See the published version of this preprint at BMC Surgery.
This is a preprint, a preliminary version of a manuscript that has not completed peer review at a journal. Research Square does not conduct peer review prior to posting preprints. The posting of a preprint on this server should not be interpreted as an endorsement of its validity or suitability for dissemination as established information or for guiding clinical practice.
Learn more about In Review
A new preprint design is coming!
We have improved readability, clarity, accessibility, and opportunities for engagement.
Research article
Weijia Liao
Laboratory of Hepatobiliary and Pancreatic Surgery, Affiliated Hospital of Guilin Medical University
Corresponding Author
ORCiD: https://orcid.org/0000-0002-8906-8612
License:
This work is licensed under a CC BY 4.0 License. Read Full License
Background: Most hepatocellular carcinoma (HCC) patients’ liver function indexes are abnormal. We aimed to investigate the relationship between (alkaline phosphatase + gamma-glutamyl transpeptidase) / lymphocyte ratio (AGLR) and the progression as well as the prognosis of HCC.
Methods: A total of 495 HCC patients undergoing radical hepatectomy were retrospectively analyzed. We randomly divided these patients into the training cohort (n = 248) and the validation cohort (n = 247). In the training cohort, receiver operating characteristic (ROC) curve was used to determine the optimal cut-off value of AGLR for predicting postoperative survival of HCC patients, and the predictive value of AGLR was evaluated by concordance index (C-index). Further analysis of clinical and biochemical data of patients and the correlation analysis between AGLR and other clinicopathological factors were finished. Univariate and multivariate analyses were performed to identify prognostic factors for HCC patients. Survival curves were analyzed using the Kaplan-Meier method.
Results: According to the ROC curve analysis, the optimal predictive cut-off value of AGLR was 90. The C-index of AGLR was 0.637 in the training cohort and 0.654 in the validation cohort, respectively. Based on this value, the HCC patients were divided into the low-AGLR group (AGLR ≤ 90) and the high-AGLR group (AGLR > 90). Preoperative AGLR level was positively correlated with α-fetoprotein (AFP), tumor size, tumor-node-metastasis (TNM) stage, and microvascular invasion (MVI) (all p < 0.05). In the training and validation cohorts, patients with AGLR > 90 had significantly shorter OS than patients with AGLR ≤ 90 (p < 0.001). Univariate and multivariate analyses of the training cohort (HR, 1.79; 95% CI, 1.21-2.69; p < 0.001) and validation cohort (HR, 1.82; 95% CI, 1.35-2.57; p < 0.001) had identified AGLR as an independent prognostic factor. A new prognostic scoring model was established based on the independent predictors determined in multivariate analysis.
Conclusions: The elevated preoperative AGLR level indicated poor prognosis for patients with HCC; the novel prognostic scoring model had favorable predictive capability for postoperative prognosis of HCC patients, which may bring convenience for clinical management.
Keywords
Hepatocellular carcinoma, AGLR, Prognosis, Biomarker
Figure 1
Figure 2
Figure 3
This is a list of supplementary files associated with this preprint. Click to download.
- FigureS1.tif
ROC of AGLR in the validation cohort (A) and the relationships between AGLR level and tumor size, TNM stage and MVI in the validation cohort (B).
- FigureS2.tif
Kaplan-Meier analysis of HCC patients’ survival in the validation cohort. High AGLR level was closely associated with a worse prognosis. Kaplan-Meier curves depict OS (A) and DFS (B) in HCC patients with AGLR > 90 or ≤ 90.
- FigureS3.tif
In the validation cohort, DFS’s patients with a score of 2 vs. 3 (p = 0.195) (A), OS’s patients with a score of 2 vs. 3 (p = 0.111) and 4 vs. 5 (p = 0.068) (B) had no statistical significance. There were statistical significance between the low-, medium- and high-risk groups (all p < 0.001) for both DFS (C) and OS (D).
- TableS1.doc
Loading...
Badges
Prescreen
This manuscript passed our Prescreen assessment
Complete author information
Appropriate declaration statements
Potential risks to human health
Prescreen
Peer Review Timeline
CURRENT STATUS: Published
View the published article at BMC Surgery.
Version 1
Posted 12 Nov, 2020
No community comments so far
Editorial decision: Major revision
On 16 Nov, 2020
Reviewer #2 agreed
On 15 Nov, 2020
Review #2 received
Received 15 Nov, 2020
Review #1 received
Received 12 Nov, 2020
Reviewers invited
Invitations sent on 12 Nov, 2020
Reviewer #1 agreed
On 12 Nov, 2020
Editor assigned
On 28 Oct, 2020
Submission checks complete
On 28 Oct, 2020
Editor invited
On 28 Oct, 2020
First submitted
On 26 Oct, 2020
Metrics
Comments: 0
PDF Downloads: ...
HTML Views: ...
Learn more about our company.
A new preprint design is coming!
We have improved readability, clarity, accessibility, and opportunities for engagement.
See the published version of this preprint at BMC Surgery.
This is a preprint, a preliminary version of a manuscript that has not completed peer review at a journal. Research Square does not conduct peer review prior to posting preprints. The posting of a preprint on this server should not be interpreted as an endorsement of its validity or suitability for dissemination as established information or for guiding clinical practice.
Learn more about In Review
Research article
Weijia Liao
Laboratory of Hepatobiliary and Pancreatic Surgery, Affiliated Hospital of Guilin Medical University
Corresponding Author
ORCiD: https://orcid.org/0000-0002-8906-8612
Badges
Prescreen
This manuscript passed our Prescreen assessment
Complete author information
Appropriate declaration statements
Potential risks to human health
Prescreen
Peer Review Timeline
CURRENT STATUS: Published
View the published article at BMC Surgery.
Version 1
Posted 12 Nov, 2020
No community comments so far
Editorial decision: Major revision
On 16 Nov, 2020
Reviewer #2 agreed
On 15 Nov, 2020
Review #2 received
Received 15 Nov, 2020
Review #1 received
Received 12 Nov, 2020
Reviewers invited
Invitations sent on 12 Nov, 2020
Reviewer #1 agreed
On 12 Nov, 2020
Editor assigned
On 28 Oct, 2020
Submission checks complete
On 28 Oct, 2020
Editor invited
On 28 Oct, 2020
First submitted
On 26 Oct, 2020
Metrics
Comments: 0
PDF Downloads: ...
HTML Views: ...
License:
This work is licensed under a CC BY 4.0 License. Read Full License
View the published article at BMC Surgery.
Background: Most hepatocellular carcinoma (HCC) patients’ liver function indexes are abnormal. We aimed to investigate the relationship between (alkaline phosphatase + gamma-glutamyl transpeptidase) / lymphocyte ratio (AGLR) and the progression as well as the prognosis of HCC.
Methods: A total of 495 HCC patients undergoing radical hepatectomy were retrospectively analyzed. We randomly divided these patients into the training cohort (n = 248) and the validation cohort (n = 247). In the training cohort, receiver operating characteristic (ROC) curve was used to determine the optimal cut-off value of AGLR for predicting postoperative survival of HCC patients, and the predictive value of AGLR was evaluated by concordance index (C-index). Further analysis of clinical and biochemical data of patients and the correlation analysis between AGLR and other clinicopathological factors were finished. Univariate and multivariate analyses were performed to identify prognostic factors for HCC patients. Survival curves were analyzed using the Kaplan-Meier method.
Results: According to the ROC curve analysis, the optimal predictive cut-off value of AGLR was 90. The C-index of AGLR was 0.637 in the training cohort and 0.654 in the validation cohort, respectively. Based on this value, the HCC patients were divided into the low-AGLR group (AGLR ≤ 90) and the high-AGLR group (AGLR > 90). Preoperative AGLR level was positively correlated with α-fetoprotein (AFP), tumor size, tumor-node-metastasis (TNM) stage, and microvascular invasion (MVI) (all p < 0.05). In the training and validation cohorts, patients with AGLR > 90 had significantly shorter OS than patients with AGLR ≤ 90 (p < 0.001). Univariate and multivariate analyses of the training cohort (HR, 1.79; 95% CI, 1.21-2.69; p < 0.001) and validation cohort (HR, 1.82; 95% CI, 1.35-2.57; p < 0.001) had identified AGLR as an independent prognostic factor. A new prognostic scoring model was established based on the independent predictors determined in multivariate analysis.
Conclusions: The elevated preoperative AGLR level indicated poor prognosis for patients with HCC; the novel prognostic scoring model had favorable predictive capability for postoperative prognosis of HCC patients, which may bring convenience for clinical management.
Figure 1
Figure 2
Figure 3
This is a list of supplementary files associated with this preprint. Click to download.
- FigureS1.tif
ROC of AGLR in the validation cohort (A) and the relationships between AGLR level and tumor size, TNM stage and MVI in the validation cohort (B).
- FigureS2.tif
Kaplan-Meier analysis of HCC patients’ survival in the validation cohort. High AGLR level was closely associated with a worse prognosis. Kaplan-Meier curves depict OS (A) and DFS (B) in HCC patients with AGLR > 90 or ≤ 90.
- FigureS3.tif
In the validation cohort, DFS’s patients with a score of 2 vs. 3 (p = 0.195) (A), OS’s patients with a score of 2 vs. 3 (p = 0.111) and 4 vs. 5 (p = 0.068) (B) had no statistical significance. There were statistical significance between the low-, medium- and high-risk groups (all p < 0.001) for both DFS (C) and OS (D).
- TableS1.doc
Loading...